1/2. Case report and summary of literature: giant perineal keloids treated with post-excisional radiotherapy.BACKGROUND: Keloids are common benign tumors of the dermis, typically arising after insult to the skin. While typically only impinging on cosmesis, large or recurrent keloids may require therapeutic intervention. While no single standardized treatment course has been established, several series report excellent outcomes for keloids with post-surgery radiation therapy. CASE PRESENTATION: We present a patient with a history of recurrent keloids arising in the absence of an ascribed trauma and a maternal familial history of keloid formation, whose physical examination several large perineal keloids of 6-20 cm in the largest dimension. The patient was treated with surgical extirpation and adjuvant radiation therapy. radiotherapy was delivered to the scar bed to a total dose of 22 Gy over 11 daily fractions. Acute radiotherapy toxicity necessitated a treatment break due to RTOG Grade III acute toxicity (moderate ulceration and skin breakdown) which resolved rapidly during a 3-day treatment break. The patient demonstrated local control and has remained free of local recurrence for more than 2 years. CONCLUSION: radiotherapy for keloids represents a safe and effective option for post-surgical keloid therapy, especially for patients with bulky or recurrent disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/2. physical therapists as scar modifiers.Hypertrophic scars, a common sequelae to burn injuries, represent an overgrowth of dermal components like collagen. To the burn-injured patient, the red, raised, rigid scars represent impaired function and distorted appearance. physical therapists modify scars by treating with pressure and stretching to minimize the devastating effects. Healing time, location of the injury, condition of the unhealed and healed areas, and treatment cost influence physical therapy. This article describes scarring and provides practical guidelines for pressure materials and stretching techniques. With an appropriate program, caring for a patient with burns becomes extremely beneficial and rewarding.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |